Objective To compare the sleep quality in the Tibetan adolescents from regions of different altitude and to explore impact factors of sleep quality in the Tibetan adolescents in high altitude regions for providing evidences to relevant interventions.

Methods We conducted a self-administered questionnaire survey at two high schools in two counties of different altitude in Tibet Autonomous Region from August to October 2 016. The participants of the survey were 97 students randomly selected in a high school in the county of low altitude (2 800 meters, low altitude group) and 227 students in the same high school but originally from the regions of high altitude (4 300 meters, migrant group), and 306 students in a high school in the county of high altitude (4 300 meters, high altitude group). Pittsburgh Sleep Quality Index (PSQI) - Tibetan Version was used to assess the sleep quality and the short form Egna Minnen Beträffande Uppfostran - Tibetan Version was adopted to measure parenting style in the participants.

Results Compared to the students of low altitude group and migrant group, the students of high altitude group reported a significantly poorer subjective sleep quality (PSQI component score: 1.80 ± 0.62 vs. 1.55 ± 0.65 and 1.54 ± 0.60, both P < 0.01), longer sleep latency (2.04 ± 0.77 vs. 1.67 ± 0.64 and 1.89 ± 0.73, P < 0.05 and P < 0.01), more sleep disturbances (2.11 ± 0.39 vs. 1.98 ± 0.38 and 1.99 ± 0.48, both P < 0.05), and a poorer general sleep quality (total PSQI score: 4.64 ± 1.93 vs. 3.76 ± 1.93 and 4.13 ± 2.00, P < 0.01 and P < 0.05) but a longer sleep duration (PSQI component score: 1.05 ± 0.33 vs. 1.13 ± 0.40 and 1.13 ± 0.37, both P < 0.05); the students of high altitude group also reported a higher daytime dysfunction in comparison to the students of low altitude group (2.13 ± 0.69 vs.1.96 ± 0.63, P < 0.05). Multivariate regression analysis indicated that sleep quality was influenced significantly by the altitude of residence and and parental rejection among the Tibetan adolescents.

Conclusion The sleep quality is affected by the altitude of residence and parenting style among Tibetan adolescent students in Tibet Autonomous Region.